Community Health Plan of Washington

Case Manager I – MSW/RN – Medicare/DSNP

Community Health Plan of Washington

full-time

Posted on:

Location Type: Remote

Location: Remote • Washington • 🇺🇸 United States

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Salary

💰 $78,960 - $122,390 per year

Job Level

Junior

About the role

  • Responsible for the operational delivery of the plan’s case management and coordination programs and processes.
  • Provides case management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness, and/or highly complex medical/behavioral and social conditions.
  • The goal is to improve members' quality of life and ensure cost-effective outcomes by using internal and community-based resources.
  • Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions.
  • Works within a multi-functional team to connect with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes.
  • Assesses, evaluates, plans, implements, and documents care of members within the organization’s clinical database system, in accordance with organizational policies and procedures.
  • Responsible for the assessment of members, including identifying and coordinating access to the appropriate level of care and treatment.
  • Uses the assessment information to assign the appropriate risk and complexity level, and create and document a care plan in coordination with the member, family and health team input.
  • Initiates a plan of care based on member-specific needs, assessment data and the medical/behavioral plan of care.

Requirements

  • Have a Bachelor’s degree in nursing, or a master’s degree in social work and/or related behavior health field (preferred)
  • Possess Current, unrestricted license in the State of Washington as a registered nurse (RN) (required) OR Current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required), OR Current, unrestricted license in the State of Washington as a Mental Health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required)
  • Have a minimum of one (1) year case management, home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR Have a minimum of one (1) year facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse/substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families.
  • Experience with those who have disabilities and knowledge of Child and Families Services
  • Have a minimum three (3) years of clinical experience in an acute care and/or outpatient setting (required)
  • Experience and proficiency with Microsoft Office products
  • Possess a Case Management Certification (preferred)
  • Have Bilingual abilities (preferred)
Benefits
  • Medical, Prescription, Dental, and Vision
  • Telehealth app
  • Flexible Spending Accounts, Health Savings Accounts
  • Basic Life AD&D, Short and Long-Term Disability
  • Voluntary Life, Critical Care, and Long-Term Care Insurance
  • 401(k) Retirement and generous employer match
  • Employee Assistance Program and Mental Fitness app
  • Financial Coaching, Identity Theft Protection
  • Time off including PTO accrual starting at 17 days per year
  • 40 hours Community Service volunteer time
  • 10 standard holidays, 2 floating holidays
  • Compassion time off, jury duty

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
case managementcare planningclinical assessmentbehavioral healthmedical treatmentoutpatient caredischarge planningrisk assessmentdocumentationcoordination of care
Soft skills
advocacycommunicationteam collaborationproblem-solvingorganizational skillsinterpersonal skillsempathyautonomy facilitationresource coordinationmember engagement
Certifications
Case Management CertificationRegistered Nurse (RN)Licensed Social Worker (LSWAA, LSWAIC)Licensed Mental Health Counselor (LMHC)Licensed Mental Health Professional (LMHP)Licensed Marriage and Family Therapist (LMFT)